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HomeMy WebLinkAbout020-1342-10-270 Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Wisconsin Safety and Building Division Sanitary Permit No: INSPECTION REPORT 597426 GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: City Village Township Parcel Tax No: Craig Zimpel TOWN OF HUDSON 020-1342-10-270 CST BM Elev: Insp. BM Elev: BM Description: Section/Town/Range/Map No: 9S. Lq 6-1 --1 'Lo Vo 32.29.19.1843 TANK INFORMATION ELEVATION DA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic y D /Z66 Benchmark r / tZ_ Grl~ , G ` M Alt. BM t iL4.., G ed R~' a, Aeration Bldg. Sewer 5 a 9 7 , r~ Holding St/Ht Inlet 5~. 9 2 St/Ht Outlet TANK SETBACK INFORMATION ' TANK TO P/L WELL BLDG. Vent t Air ntake ROAD Dt Inlet Dt Bottom Septic 7 `1A / 15-7 Dosing 7v Header/Man. Aeration Dist. Pipe 74 71 `9 Holding Bot. System 93 Final Grade , T PUMP/SIPHON INFORMATION G'' Manufacturer DePlmNand St Cover Jib itg. 00, ` ; 7 1 Model Numb TDH Lift Friction Loss System Hea H Ft Forcemain Length Dist. to Well mb SOIL ABSORPTION SYSTEM BEDITRENCH Width Length No. Of TrenchesQ PIT DIMENSIONS No. Of Pit- Inside Dia.Liquid Depth DIMENSIONS ~ 13 1 SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacture INFORMATION CHAMBER OR Type Of System: UNIT Mode umber: ~c~ JQ~ 6 7 N ,V Wa DISTRIBUTION SYSTEM Zs O-Z: -ZS ~7S v S Header/Manifold Distribution x Hole Size x Hole Spacing Vent to Air take Pipe(s) Length ' Z Dia Length Dia Spacing SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over Depth Over To Depth of Seeded/ ddxx Mu ched Bed/Trench Cr Bed/Trench Edges psoil Yes D No s ~ No COMMEN S: (Include code discrepencies, persons present, etc.) Inspection #1: Inspection #2: Location: 515 CARRIAGE LfV, 1.) Alt BM Description = 2.) Bldg sewer length = - amount of cover Plan revision Required? Yes No I C ' it G3 Use other side for additional information. L p #gnatu Cert. No. Dat e InsSBD-6710 (R.3197) IRTIt Safety and Buildings Division ~CE'VED 201 W. Washington Ave., P.Q. Box 7162 Sanitary Permit Number (to be filled in by Co.) Madison, WI 53707-7162 ~tia s JUL 1't~11 lit -ML ; 5 ? t12 (40 State Transactio Number Nas jommu, W&" mit A DZDKOOY7CB14Y In accordance with SPS 383.21(2), Wis. Adm. Code, submission Y~v ure g M unit L is required prior to obtaining a sanitary permit. Note: Application forms for state v ed S e su ed Project Address if different than mailing address) the Department of Safety and Professional Servies. Personal information you pr se purposes in accordance with the Privacy Law, s. 15.04(1 (m , Stats. Q ` foo ~15 ~ 1 Ca 1. Application Information - Please Print All mation ? Q45 vJ parcel Property Owner's Name ~M6 ~ 6% Property Location~+ Property Owner' ailing Address Location, 3 il ~tl - iq ^ 13 q 3 Govt. Lot City, State Zip Code Phone Number Section_ (circle one h N /C T ~y N; R E W I~) e. R. Type of Buildirk~ (check all that apply) Lot 4 '7 Subdivision N am 511 or 2 Family Dwelling -Number of Bedrooms _ j eX ~ Ok Blo se rr t. ❑ Public/Commercial Describe Use ❑ City of J `4N` CSM Number ❑ Village of ❑ State Owned -Describe Use - ❑ Town of 3 rpt(5 1,J) 41-1 - L.. / -r, - III. Type of Permit: (Check only on box on line A. Complete line B if applicable) p y~Q„r [A. X New System ❑ Replacement System ❑ Treatment/Hoiding Tank Replacement Only ❑ Other Modification to Existing System (explain) - - - - - List Previous Permit Number and Date Issued ❑ Permit Renewal ❑ Permit Revision ❑ Change of Plumber ❑ Permit Transfer to New Before Expiration Owner N. Type of POWTS System/Component/Device: (Check all that apply) Non-Pressurized In-Ground ❑ Pressurized In-Ground ❑ At-Grade ❑ Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil ❑ Holding Tank Other Dispersal Component (explain) ❑ Pretreatment Device (explain) V. DispersallTreat nt Area Information: Design Flow (gpd) Design Soil Application Rate(gpdsf) Dispersal Area Required (sf) Dispersal Area Proposed (sf) System Elevatti n,~~~ ~ /S©d ti to Y V C VI. Tank Info Capacity in Total # of Manufacturer Gallons Gallons Units 2 , ~ New Tanks Existing Tanks / P. w G ~U i7, t~ Septic or Holding Tank ~C'~;: Dosing Chamber VII. Responsibility Statement- I, the undersigned, assume responsibility for installation of the POWTS s own on the attached plans. Plumber's Name (Print) Plumber's Signature RS Number Business Phone Number Lcl, l i:cft 1i/~ ~7 un) zti;e~, h--- Plumber's Address (Street, City, State, Zip Code) VI ounty eplirtment Use Only Permit Fee Date ssue Issuing ent Signature Approved ❑ Q Q ❑ en Reaso for Denial S v t/ Z f r A. Condi4N*TI q)WWWReasons for Disapproval 3~ L G~ I 1. fir tank, ®tutn A w ma J I1.t11tt~~l. N~ u~.-~ uisper.:su cell must all be s,~ilc!2s ! r j~ mf~;r e~ IT ~ IS per Toaragement plan pto ided by pluinbei. / , ✓ ^ 2. 'All 8001 k regWMtl il" mustUY rtasrt. it E i as per appiktble cock / ardirm x cz. - Attach to complete plans for the system and submit to the County only on paper not less than S 12 s 11 inches in sizr. SBD-6398 (R. 1 I/11) Vii/ L ~ G 'YI ~ ~ ✓ I f ~ I lam, 1 4 / ItE i%~ t ffl f i 0 C1 ' I V I ~ r r. ` 1 D 1 %T CONVENTIONAL COMPONENT DESIGN Residential Application INDEX AND TITLE PAGE Project Flame:' 1 , ()wr►(-r's Natne: c r Ovuner's Address. - - - CA ega4 t.lra~;r:ril~t4nrt: ~~Tl % S Z .1 c l % li L~tn~rxshl{~; ' r_.r~Raa~1,y; >ukidh~isio4a Name; jw , ,1Jd c s c t 7 I of Number Pal'c:ot If) Wanher: d C 1-3~f page 1 Index and title Page Plot Plan Page slar `alzl4l & 4 mss" section Page F'a9E r -MaintenFance Intotmation Page 6 - ^ ---_1tfle~te~ment I="l~ln T _ Pager fit. c;r°olx C(y Septic Tank Maintenance Form Page 8 Page 4 c8m at, flat Attaohtner4ts: 5ai1 `Ie~t & l-Iorase plans Ies19Ilerlt'lia+tik)er; ~ , i , _ Nurither; Oates SI4~ 41~tt arr--± rie rrgrr~c,4 pursuers rn t4tr 4n-Umiand L'3011 Ahvorptlon CorYipnnr::ni pllai~rral fnr i'(~lAl1 S /ersir~n 2.tr $BQ-1o7~5t' (4d,Ot!(11). raQ~; r w~1 - ( f jec, j, 3x'~ Tr e vc, s a 13 3 ACC ~~i5~ ~rz-Y I i 0 d i Soil Absomtion Swrstgm Cross Section C0~ 4" Schedule 40 Final e r'VC Vent Pipe Nth Vent Cap Leaching t Chamber ~Y_-- System Elevation ft ft ff Soil Absorption %rstem Plan Viewer /4,4' ` ft ft Ti] J] ft f Leaching Trench 1 Chambers 4" Die. Trench 2 Hewer Vent Or Observation Pipe i L Leaching_ ghomber spe,cffirM#ons ManUfacturarAnd Model 6 EtsA Rating o? sq ft per chamber Soil Appiicatlon Rate / jg~-~ gpolsq ft 1`tO-qpd Design Flow ~ je- Soil Application Rate z 0 EISA = - ~ 7 r - . Charnbers 3 rows of ~26 chambers each. Page Of 1 I POWTS OWNER'S MANUAL & MANAGEMENT PLAN Pago of FILE INFORMATION SYSTEM SPECIFICATIONS Owner s/ i11 t=' C Septic Tank Capacity $ t"J al ❑ NA Permit # J°°- ❑ QUA Septic Tank Manufacturer DESIGN PARAMETERS Effiuept Filter Manufacturer [:J NA Number of Bedrooms q NA Eff(uont Filter Model Q NA Number of Public Facility Units (Zl NA P14MP Tank Capacity g o Z) O NA Estimated flow (average) - ^T `Purrs Tank Manufacturer - - 1-1 NA Design flow (peak), (Estimated x 1.5) d al/ tly Pump Manufacturer ok ❑ NA Soil Application Rate Pump Model NA Standard Influent/Effluent QRtality Monthly ayarpFrotr e.1 ment Unit L1 NA Fats, Oil & Grease (FOG) mg/L 0 Sand/Gravel Filter 0 Peat Filter Biochemical Oxygen Demand (BOb~► i 5220 mg/l. ❑ NA E1 Mechanical Aeration O Wetland - ^ -,Total Suspended Solids (TSS) !A 50 mg/L 0 Disinfection 0 Other: Pretreated Effluent Quality Monthly average plapersal Callis) C] NA Biochemical Oxygen Demand (1300,j) mg/l. Q in-Ground lgravity) Q In-Ground lpressurized) Total Suspended Solids (TSS) s30 mg/l, P NA, 0 At=Grade ❑ Mound - -Fecal Colifornt (geometric mean) a10' cfu/`i90Ml Q prlp-,.ine EJ Other: Maximum Effluent Particle Size Y. in din. Q NA Other ❑ NA Other: NA Other; Q NA "Vahaes typical for dornestic wastewater and septic tank effluent ' Other; Q NA MAINTENANCE SCHEDULE Service Event Service Frequency inspect condition of tank(s) At least lance every: month(s) (IVlaximum 3 years) 1.1 NA Pump out contents of tankisli J -Y When combir100 sludge and scum equals one-third 4%) of tank volume 0 NA _ Inspect dispersal cell(s) At least once Mever yl 0 month(s) (Maximum 3 yearns) ❑ NA year(s) Clean effluent filter At )oast once every: El month(s) ~ fa NA Inspect pump, pump controls & alarm At least once every: El month(s) 0 A 0 year(s) Flush laterals and pressure test At least grlop every: 0 month(s) El Q NA year(s) 00er: At le 13 month(s) 11 NA least ranee every: D year(s) ❑ NA MAINTENANCE INSTRUCTIONS Inspections of tanks and dispersal cells shall be made by an ipolvidual carrying one of the following licenses or certifications: Master Plumber; Master Plumber Restricted Sewer; POWT$ Inspector; POWTS Maintainar; Septage Servicing Operator. Tank inspections must include a visual inspection of the tank(s) tf Identify, any missing or broken hardware, identify any cracks or leaks, measure the volurni3 of combined sludge and scum end to check for any back up or ponding of effluent on the ground surface. Tlie dispersal veil(s) shall be visually inspected to chock the off,.lpgnr t levels In the observation pipes and to check for any ponding of effluent on the ground surface. The ponding of effluent on the ground surface may indicate a failing condition and requires the intrnediate notification of the local regulatory authority, When the combined occurnulation of sludge and scum in any .tank equals one-third (Y.,) or more of the tank volume, the entire contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with chapter NH 113, Wisconsin Administrative Code. All other services, including but not limited to the servicing of effluent filters, mechanical or pressurized components, pretreatment +.nnits, and any servicing at intervals of 02 months, shall be performed by a certified POWTS Maintainer. A service report shall be provided to the local regulatory authority within 10 days of completion of any service event. START UP AND OPERATION f aqe _ ref For new ronstructirrn, prior to L196 Of the POWTS rheizli #rpa#rneint tank(a) for the presence of painting products or other chemicals that may impede the treatment process and/or dalneps the 41aperaol1 cell(s), It high poncentrations are detected have the contents of the tank(sl removed by a saptage servicing operator prior fib u0e, System start up shall not occur when soil conditions are fr006 at the Infiltrative surface, Disring power outages pump tanks may fill above normmil hlohv oipr lovols, When power is restored the excess wastewater will be dincharged to the dispersal cell(s) in one large dos0r erlyt i[~g thO a$IiIA) qnd may result in the backup or surface discharge of efitraeni. To avoid this situation have the contents tt tfiC! PO k qlp top rdmoytad by a Septage Servicing Operator prior to restoring power to the effluent pump or contact a Plumber or POW T$ MAIntaltter to assist In manually operating the pump controls to restore normal levels within the pump tank. Do not drive or park vehicles over tanks and dispersdl,cells, pd ngt;q llve or park over, or otherwise disturb or compact, the area within 15 feet down slope of any mound or at-grade soil abmprOo,n ,aroo. Reduction or ralimination of the following from rise was#ewatsr stream rrtAry improve the performance and prolong the fife of the r'OWTS: antibiotics; hahy wipes; cigarette butts; 061nooi i; oo~ttpr,avydos; degreasers; dental floss; diapers; disinfectants; fat; foundation drain (sump pump) water; fruit and ve$te paWljnll ~amaline; grease; herbicides; meat scraps; medications; oil; painting products; pesticides; sanitary napkins; tampons; and w0tt'it aaftar(ar brine. ABANDONMENT When the POWTS fails and/or is permanently taken out of geryioe'the following steps shat( be taken to insure that the system is properly and safely abandoned In compliance with bhapter C6rhrn 83,331 1lliisaansin Administrative Code: a All piping to tanks and pits shall he disconnrfcted And t~l+a 013OM 116(1 pipe openings sealed. ® Fhe contents of all tanks and pits shall be rialnov d a fA and properly disposed of by a Septage Servicing Operator. e After primping, all tanks and pits shall be excAjvataq dnd rerttoVed or their covers removed and the void space filled with soil, gravel or another inert solid material, CONTINGENCY PLAN If the POWTS fails and cannot be repaired the following massorgs have been, or must be taken, to provide a code compliant replaeement system; 1-1 A suitable replacerent area has been evaluate t and may be utilized for the location of a replacement soil absorption system. The replacement area should he protodted from (ilsturbanee and compaction and should not be infringed upon by required setbacks from existing and proposed ON6turbl ldt 1,1000 mind welts, Failure to protect the replacement area will result in the need for a new soil and site evaluation to e00411sh a suitable replacement area, Replacement systems must comply with the rules in effect at that time, C-1 A suitable replacement area is not availabip dus to setback and/or soil limitations. Barring advances in POVdTS technology a holding tank may be installed ds a Idg{ resort to replace the failed ROWTS, ~C7 The situ as no~en evaluated to identity ti suitabld 1.epfdQ may pmant area. Upon failure of the POWTS a soil and se evaluation be performed to locate a syllable reW) IRaM Ilt MR, If no replacement area is available a holding tank b0-i afte s a last resort to replace the toiled oow 1-1 Mound and at-grade soil absorption systerrts infiltrative surface. play be racopistructed in place following removal of the biomat at the Reconstructions of such systems rrjtt0t taorripiy with the rules in effect at that time. < WARNiNQ > > SEPTIC. PUMP AND OTHER TREATMENT TANKS MAY CONTAI k GASSES AND/OR INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP on t~THER TREATMENT TANK t~ 611Ip~~CUMSTANCES, DEATH MAY RESULT, RESCUE OF A PIERSCIN FROM THE INTERIOR OF A TANK MAY BE i lorlc`uL dot MaSfLE, 40DI?IONAL COMMENTS - - - - `DWTS INSTALLER t TAIN4 Name ! - latrie Phone / "M - --Phone EPTAGE SERVICING OPERATc7R (P>fMPER) Name DILATORY AUTHORITY phone LNo tt ~5 -3q -~6gp cis ctnrumnrit wary drnfted in cnmrilian~e~ with chapter Comm $3422(21(bllIlIM&M And 93.54(1), (2) & (3), Wisconsin Administravvo Code. ST. CROLX COI-IffY SEPTIC T-42\rK NLAD\7ENANCE AGREEMENT AND OwNTR= CERTIFICATION FORM Owner/Buyer,~, dt A L. 1ldUng Address o1,A-, f v'rc 7 I~ S Property Address 4:5~ n1ily'Rej A r ~✓r (verification required from Mu6bg & Zoning Department ' Wnew 41 'on.) City/State #zrcrl >n . Parcel Identification Number d 24 ~ 11342 A6 - 076 LEGAL DESCRIPTION Property Location '-/4 . Sec. LX,' , T _N R / w, Tour of f>4 f. Subdiinsion Plat Tpon t t Lot #.14 Certified Survey Map # Volume , page # Warranty Deed # (before 2007)Volume , Page* Spec house 0 yes 0 no Lot lines idei§able),yes 0 no SYSTEM MAIlYTENANCE AND OWNER CERTIFICATION Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper main=ance consists of pumping out the septic tank every three years or sooner, if needed, by a licensed pumper. What you put into the system can affect the fimction of the septic tank as a treatment stage in the waste disposal system Nmer maintenance responsibilities are specified in §SPS. 38352(1) and in Chapter 12 - St Croix County Sanitary Ordinance. The property owner agrees to submit to St Croix County Planning & Zoning Department: a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on-site wastewater disposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 fall of sludge. Uwe, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Safety And Professional Services and the Department ofNatural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St Croix Cormry Planning & Zoning Department within 30 days of the three year expiration date. Vwe certify that all statements on this ern are true to the best of my/our knowledge. I/we am/are the owner(s) of the property described above, by virtue of a wa y deed recorded in Regster of DEe5ds Of c• c. Number of bedrooms SIGNAcfURE OF APPLICANT(S) DATE C j A.ny information that is misrepresented may result in the sanitary permit being revoked by the Planning & Zoning Department Include with this application a recorded warty deed from the Register of Deeds Office and a copy of the cea-afied survey map if reference is made in the warranty deed (REV. 04/12) zp ~z oa oa og Y zZ ~y mWZ Wmz toZ mm O OO < vii on ffi 4 0~ 0 0 of F 900 >e~ ag ~ ~ Y ~ ~oo ~ ~ ~ ?m OJJpZ Jpp= JppZ J? ~ ~ Y l` ' G a k kk DI 91 F 4 F-~< F-J4 FK mZn O c~ Ed: d° lSd° 1loH OK OoK DOW OoK O< t ma Oro 0F_0 0~0 00. ga s: O 3~ S ZI U 2 C~ ~ J z .107 ~ ~ 1001 j 'b -'70A ~ A'S'0 ~ L6El O<f S 70A 8 LO7 I 3 1 - w 1 1 i lP S'0 , ^ 9 LQ 1 T- --l 107---4 „ ~E W N-- J ro,rl,ll S C67-9-ST M ,.tO F1 11 I QVOtf- 7-1SN,01 < r I V 3 ..9l.SS.00 S S~ ICtI m ^ -I _40 cr91 -t9 ac. 10 C I n.cto~3. v .999611 G1o It 3 ..21,00AD S .00•ofC - in r` 3.51' f0' r'ta~ • 4r s _ onond 3 „9l,SS.00 S--~ - 9f9 - •Ct'6 9~~ ]11( aG "'Ofola Wi °o ~x < 8 1 r _ - - a9 a C4659 3 .Ys a..1a z is -1,x9. cn Z6 «p t ~x S S)' R«n / 3+~tf{o~ 1 . e 1 Nye /.~g~ 9p.~ x N {pz j aso w _ s _eA 14 ° \ ,yo xta \ \Oy•/ ~-0 q,a / .rr~~r 3 ea'ct1 (d$9oso \ r~\ w<R yl4i x~ ofd ~~~5\~°r N'C•' i `y • IJ W , ~ i ~i q ~ ~I 'fib ~ ; \ ' ~ 4~~~, s~~q ~ n g ~ \ ~ • ~ ~yp. 03.9 ~1~ Doan <d^N~ `7 \ N i ;9 e~ ~8 t'f O p °n - + I ; \ S'S H P1'SSy t" w ]59.ei 19 F: -xa..tezisa-- pCB x 21919' w - 1 h O r. Y n -It 959 '29•' M_. yt.~ %.G~)?a 1 « 1< o t .r . „ ~'l 1 R 0?I NI10176 O A C4 is+\- - - - - fit)„ 1 3 / ne 3m 01 miralmo T/1 e o Put ~ M •`Nda•11'S3" 1 V S qq 5 5 \ . ri%sa J \ .....l....~ . ...1•s••'~ \ w f~" ~ s o ~ ~ \ ray ~MH Ati ,eons ~.coSGioN G~, V / 14' 'Ir i / , yti~ t ~ `e . / N t r l t o q << t?' r~t1' \ -\*.1 ~t y' ~~,P 'nb ° w„ rb,-,' w~ I H wnh tipf \ =Y \ 0 MAI Iv\- " t9tio x x ♦y G9n 31LL so 9/13s 3~t !A 3161 G639 C~ -\+.t• yz ----j- x j 91jC9Zl M .,S*,06.0b N ; 1 1 I 21 x 1 1 ~ 1 ; ~ o ~ ; ' ~ V CO N' 1 I i F.' I yl 1 w i l ILI ; F.3, Ei~ <I 1 ~t.l I 1 1 V~IE.1 1 yI~ 1 ~iE,. I l a; ~ I I I 1 ~ I I Wisconsin Department af~tPr'~ Yrofessional Services Page 1 of 2 Division of Ir V/ 1-%{:w SOIL EVALUATION REPORT 30L 27 r ZW, In accordance with SPS 385, Wis. Adm. Code County Attach complete site p Gwbk Us~tW 8 1/2 x 11 inches in size. Plan must include, St. Croix but not limited to: S& r ce point (BM), direction and percent slope, Parcel I.D. scale or dim ow, and location and distance to nearest road. 020-1342-1 -270 Ref #2481 Please print all information. Reviewed D to Personal information you provide may be used for seconds purposes Privac Law, s. 15.04 1 m . 7, '7 Property Owner Property Location ell ❑ Craig Zimpel Govt. Lot NW '/4 NW '/4 S 32 T 29 N R 9 E (or) W _a Property Owner's Mailing Address Lot # Block # Subd. Name r CSM# 1781 Lamplight Dr. 27 na Windsor Heights City State Zip Code Phone Number ❑ City ❑ Village ®Town Nearest Road Woodbury MN 55125 ( ) Hudson ® New Construction Use: ® Residential/ Number of bedrooms 4 Code derived design flow rate 600 GPD ❑ Replacement ❑ Public or commercial - Describe: Parent material Glacial Till Flood Plan elevation if applicable na ft. General comments and recommendations: Evaluation completed to verify loading rate of tested area. Site suitable for In-ground POWTS with 0.4 gpd/sq. ft. loading rate with infiltrative surface elev. to be 94.25' (approx. 20" - 33" below grade). 1❑ Boring # ❑ Boring ® Pit Ground surface elev. 95.69 ft. Depth to limiting factor >95" in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/Ftz In. Munsell Qu. Az. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-24 10yr2/1 none L 2fgr ds cw 2vf,fm 0.6 0.8 2 24-30 10yr3/3 none sil 2fsbk mvfr cw 2vf,fm 0.6 0.8 3 30-47 10yr4/4 none sil 2f&msbk mfr cw 1vf,fm 0.6 0.8 4 47-78 5yr4/4 none grsl 1csbk mfi cw 1vf,f 0.4 0.7 5 78-95 5yr4/4 none sl 0M dsh - 0.2 0.6 ❑ Boring # ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. I Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/Ft2 In. Munsell Qu. Az. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 * Effluent #1 = BOD, > 30:5 220 mg/ and TSS > 30!5 _ 150 m /L * Effluent #2 = BOD, > 30!5 220 mg/L and TSS > 30:5150 mg/L CST Name (Please Print) Signature CST Number James K. Thompson • ~ 30021 Address Date Evaluation Cond ted Telephone Number 340 Paulson Lake Lane, Osceola, WI 54020-5413 July 24, 2017 (715) 248-7767 SBD-8330 (R04/15) LD c4'Ec c~~ ro/Jt/E~. Stu,[ .sa/ Q✓a/uaiL-1'1~,n/.1,2 6y 0 6,4e W `/14,/y7' eLo~ Aar 5Za/ /Iwy~rlWyf Sec 3.2, T.2y~l~ K. /9~. Qe c~ni : 7 ~F/~ 5 ~•c r' dson, S~ . Croix C'o. , J/. O f~G/. U2D -13i;l _i0 -Z70 So,% ¢va ~~a / t ////4,/9/. 10/ 0 I t / 1 ! x,2.21 ~ ~ I r N , C~//'ra 9 C i~ '✓y 2 J,_ rvisconsin Department of Commerce ' SOIL AND SITE EVALUATION Division of Safety and Buildings Page of S Bureau of Integrated Services in a (dance,lniith Z, tWR 83.09, Wis. Adm. Code County Attach complete site plan on paper not less than 8 /2x 11 inglIes ik' bim- Plan must include, but not limited to: vertical and horizontal jeerence pcugf. (f fbl), direction and percent slope, scale or dimensions, north arrow, location and distance to nearest ri ad. Parcel I.D. # APPLICANT INFORMATION -Please tall infbrrnatlon. ' j-/ Reviewed b Date Personal information you provide may be used for second ryPucposes (Privacy Law,, ~.F15.t~E(4). /Z Property Owner t; erty Location ovt. Lot 1/4 1/4,S T N,R 12~(or)* Pro erty Owner's Mailing Address Lot # Bloc Su dame or CSM# ILA; WT S City State Zip Code Phone Number ❑ City Village Town Nearest Road Z/-) _LL New Construction Use: Residential / Number of bedrooms Addition to existing buil 'ng Replacement Public or commercial - Describe: Code derived daily flow - gpd Recommended design loading rate , bed, gpd/fe trench, gpd/ft2 Absorption area required gibed, ft2 /D,~,trench, ft2 Maximum design loading rate , bed, gpd/fi2_,~trench, gpd/ft2 Recommended infiltration surface elevation(s) ft (as referred to site plan benchmark) Additional design/site considerations Parent material , r!~ Flood plain elevation, if applicable ft s Suitable for system Conventional Mound In-Ground Pressure AT-Grade System in Fill Holding Tank UUnsuitable for system ED S ❑ U ® S ❑ U [as ❑ U ® S ❑ u ❑ s IA U ❑ S ]z U SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Structure GPD/ft2 g Texture Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed ,Trench Ground elev. ft. c' Depth to limiting factor Remarks: Boring # r 7 C 1 Ground elev. _ X12-ft. Depth to limiting factor 7.5in. Remarks: CST Name ( lease rint) Telephone No. Address Date CST Number SOIL DESCRIPTION REPORT PROPERTY OWNER f> Page of ~ PARCEL I.D.#~ Boring # Horizon Depth Dominant Color Mottles Texture in. Munsell Qu. Sz. Cont. Color Gr. Szt Sh Consistence Boundary Roots 2 Bed Trench Ground , j elev. - _ Depth to limiting factor Remarks: Boring # Ground elev. may, - Depth to limiting factor Remarks: Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench Boring # ZZ, el a, 4ZI Ground c ~elev. Depth to limiting factor >-2L1n. Remarks: Boring # Ground elev. ft. , Depth to limiting factor in. Remarks: SBD-8330 (R. 07/96) i PROPERTY OWrER SOIL DESCRIPTION REPORT Page of _Y ' PARCEL LD.0 J,~~?7 Boring # Horizon Depth Dorrrnent Color Mottles Stnrcture C;onsistence BGewe 1 in. Munsell Ou. Sz. Cont. Color Texture Gr. Sz. Sh. Boundary Rooms Bed . Trench Ground 3 7, T Depth to iimHing factor Remarks: ring # / Bo sum Ground 4 elev. ' Depth to Nndting factor Remarks: Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots in. Munsell Uu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench Boring # _ 41Z 9=2,M I I 1 17r 44/4 I , Ground elev. Depth to tlnuitlng factor Remarks: Boring # I Ground elev. ft. ' Depth to Orn" factor in. Remarks: SBD-8330 (R. 07/96) 1 I 1 i I ' 1 I i _ e~ / Parcel 020-1342-10-270 02i27i2008 03:54 PM PAGE 10F1 Alt. Parcel 32.29.19.1843 020 - TOWN OF HUDSON ST. CROIX COUNTY, WISCONSIN Current X Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co-Owner O - WEST LAKE, BUILDERS INC BUILDERS INC WEST LAKE PO BOX 703 HUDSON WI 54016 Districts: SC = School SP = Special Property Address(es): = Primary Type Dist # Description ' 515 CARRIAGE LN SC 2611 HUDSON SP 1700 WITC Legal Description: Acres: 1.061 Plat: 07-016-WINDSOR HEIGHTS LTS 1/27 1998 SEC 32 T29N R1 9W PT SE NW WINDSOR Block/Condo Bldg: LOT 27 HEIGHTS LOT 27 1.061AC Tract(s): ( 9 Sec-Twn-Rn 401/4 1601/4) 32-29N-19W SE NW Notes: Parcel History: Date Doc # Vol/Page Type 2008 SUMMARY Bill Fair Market Value: Assessed with: 0 Valuations: Last Changed: 10/25/2005 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 1.061 48,300 0 48,300 NO Totals for 2008: 48,300 General Property 1.061 48,300 0 Woodland 0.000 0 0 Totals for 2007: 48,300 General Property 1.061 48,300 0 0 Woodland 0.000 0 Lottery Credit: Claim Count: 0 Certification Date: Batch Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges 00 Total 0.00 0.00 SS 3NII AVM -40 JH018 OV08 p 3N!'1 101 r. 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